Image Quality and Radiation Dose for Fibrofatty Breast using Target/filter Combinations in Two Digital Mammography Systems

Objectives: The aim of this study was to determine the optimum combinations of target and filter materials for various X-ray tube voltage settings, as well as their effects on image quality and radiation dose. This was done using different digital mammography (DM) imaging systems with a breast equivalent phantom. Material and Methods: Two DM units with a tungsten (W) target, silver (Ag), and rhodium (Rh) filters and dual molybdenum (Mo) and Rh targets/filters were used. A tissue-equivalent mammography phantom of 6 cm thickness equivalent to a fibrofatty breast was exposed 20 times to different target/filter material combinations (W/Rh, W/Ag, Rh/Rh, Mo/Rh, and Mo/Mo) and various kV settings (28–34 kV). The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated for each exposure. Results: The W/Ag combination resulted in the lowest entrance skin dose and mean glandular dose (MGD). The MGD for the W/Rh combination was 60% less than that of the W/Ag combination at 34 kV ( P < 0.05). There was a direct relationship in the SNR with the Mo/Mo, Mo/Rh, and Rh/Rh combinations and an inverse relationship with the CNR in the 34 kV range. There were statistically significant differences between all five target/filter combinations, and the best SNR and CNR were observed for the W/Rh combination with a reduced radiation dose in the range of 28–30 kV ( P < 0.05). Conclusion: For a breast thicknesses of 6 cm with a fibrofatty nature, the W/Rh combination delivers high performance in terms of image quality at a lower dose.